Are women making informed choices with regard to Combined Ultrasound and Biochemical (CUB) screening in the first trimester of pregnancy?

Background: Previous studies report that women are failing to make informed choices with regard to antenatal screening, due to significant deficits in knowledge. However, current definitions dictate that informed choice occurs not merely as a result of sufficient knowledge, but by acting in line with one’s attitudes despite perceived social pressure (Dormandy et al., 2002). Objective: To investigate whether women are making informed choices with regard to Combined Ultrasound and Biochemical (CUB) screening, using more substantial criteria. Design: Prospective non-experimental. Setting: The Queen Mother’s Maternity Hospital in Glasgow. Sample: 63 women due attend their first antenatal appointment. Outcome measures: responses to a questionnaire constructed for the purposes of the study. Methods: A multidimensional questionnaire measure encompassing demographic factors, areas of knowledge recommended by The Royal College of Obstetricians and Gynaecologists (RCOG, 1993) and all aspects of the Theory of Planned Behaviour (TPB; Ajzen, 1985). Results: Women appeared to be well informed, though there were some worrying misconceptions. Women appeared to intend to act in line with their attitudes, although small numbers of women planning to refuse screening limited findings. Attitude was the strongest predictor of behavioural intention. Conclusions: There appears to be moderate support for the hypothesis that women would make ‘informed choices’, though this is limited by a number of factors which require further investigation

Chapter 15- Things are Different Now A Student, Staff, and Faculty Course Design Institute Collaboration

Like other institutions across the world, Georgetown University in Washington, DC switched to remote learning in March 2020 as the COVID-19 pandemic hit the United States. Our Center for New Designs in Learning and Scholarship (CNDLS), which serves as both a center for teaching and learning as well as a center for technology innovation, responded quickly with a series of offerings to prepare and support faculty to teach remotely. Options included a virtual conference on digital pedagogy, a series of cohort-based Course Design Institutes (CDI) throughout the summer where faculty engaged with intertwined principles and best practices from inclusive pedagogy and online course design; and a series of workshops on select teaching topics. As with so many other centers for teaching and learning, we saw a rapid increase in faculty participation as instructors planned for fall 2020 remote courses. We worked with over 1,800 unique faculty through our summer conference, CDIs, and other engagements

MUS81 Generates a Subset of MLH1-MLH3–Independent Crossovers in Mammalian Meiosis

Two eukaryotic pathways for processing double-strand breaks (DSBs) as crossovers have been described, one dependent on the MutL homologs Mlh1 and Mlh3, and the other on the structure-specific endonuclease Mus81. Mammalian MUS81 has been implicated in maintenance of genomic stability in somatic cells; however, little is known about its role during meiosis. Mus81-deficient mice were originally reported as being viable and fertile, with normal meiotic progression; however, a more detailed examination of meiotic progression in Mus81-null animals and WT controls reveals significant meiotic defects in the mutants. These include smaller testis size, a depletion of mature epididymal sperm, significantly upregulated accumulation of MLH1 on chromosomes from pachytene meiocytes in an interference-independent fashion, and a subset of meiotic DSBs that fail to be repaired. Interestingly, chiasmata numbers in spermatocytes from Mus81−/− animals are normal, suggesting additional integrated mechanisms controlling the two distinct crossover pathways. This study is the first in-depth analysis of meiotic progression in Mus81-nullizygous mice, and our results implicate the MUS81 pathway as a regulator of crossover frequency and placement in mammals

Domestic Abuse and Gender Inequality: An overview of the current debate

Domestic abuse is a global phenomenon which adversely affects individuals who experience it and creates social and financial burdens for the societies in which it occurs. While abuse can be perpetrated by women against male partners and occurs in same sex relationships, domestic abuse is overwhelmingly perpetrated by men against female partners. As a result, the United Nations has identified domestic abuse as a form of gender based violence that is predominantly experienced by women and perpetrated by men (United Nations, 1992). Domestic abuse is both a cause and consequence of gender inequality. This briefing will provide an overview of a gendered analysis of domestic abuse, outline the evidence which supports this and the debate which challenges it

Factors influencing implementation and sustainability of interventions to improve oral health and related health behaviours in adults experiencing severe and multiple disadvantage: a mixed-methods systematic review

OBJECTIVES: Among people experiencing severe and multiple disadvantage (SMD), poor oral health is common and linked to smoking, substance use and high sugar intake. Studies have explored interventions addressing oral health and related behaviours; however, factors related to the implementation of these interventions remain unclear. This mixed-methods systematic review aimed to synthesise evidence on the implementation and sustainability of interventions to improve oral health and related health behaviours among adults experiencing SMD. METHODS: Bibliographic databases (MEDLINE, EMBASE, PsycINFO, CINAHL, EBSCO, Scopus) and grey literature were searched from inception to February 2023. Studies meeting the inclusion criteria were screened and extracted independently by two researchers. Quality appraisal was undertaken, and results were synthesised using narrative and thematic analyses. RESULTS: Seventeen papers were included (published between 1995 and 2022). Studies were mostly of moderate quality and included views from SMD groups and service providers. From the qualitative synthesis, most findings were related to aspects such as trust, resources and motivation levels of SMD groups and service providers. None of the studies reported on diet and none included repeated offending (one of the aspects of SMD). From the quantitative synthesis, no difference was observed in programme attendance between the interventions and usual care, although there was some indication of sustained improvements in participation in the intervention group. CONCLUSION: This review provides some evidence that trust, adequate resources and motivation levels are potentially important in implementing interventions to improve oral health and substance use among SMD groups. Further research is needed from high quality studies and focusing on diet in this population. PROSPERO REGISTRATION NUMBER: CRD42020202416

COVID-19 and the role of Voluntary, Community, and Social Enterprises in northern England in responding to the needs of marginalised communities: a qualitative focus group study

Background: The Voluntary Community and Social Enterprise sector has a crucial role in supporting the health and wellbeing of people who are marginalised or who have multiple complex needs. We aimed to understand perceptions of those working in the sector and examine the short-term, medium-term, and long-term effects of COVID-19 on Voluntary Community and Social Enterprise organisations in northern England as they respond to the needs of marginalised communities. This research formed one component of a regional multiagency Health Inequalities Impact Assessment. Methods: We conducted qualitative focus groups with staff and volunteers from five organisations between March and July, 2021, via a video conferencing platform. Eight of nine focus groups were audio-recorded and transcribed verbatim. One focus group was not recorded due to concerns raised over anonymity and safeguarding, but non-ascribed fieldnotes were taken. Focus group transcripts were analysed using framework analysis. Findings: One organisation supported children and young people; two organisations supported vulnerable women, young people, and families; one organisation supported refugees and asylum seekers, and one organisation supported disadvantaged individuals to improve their mental and physical health and wellbeing. Three central themes were identified: the exacerbation of pre-existing inequalities, adversity, and challenges for vulnerable and marginalised populations; the cost of being flexible, innovative, and agile for Voluntary Community and Social Enterprise staff and volunteers; and the voluntary sector as a lifeline (organisational pride and resilience). Interpretation: The considerable expertise, capacity, and resilience of Voluntary Community and Social Enterprise organisations and the crucial role they have in supporting marginalised communities has been clearly shown in their response to the COVID-19 pandemic. The Voluntary Community and Social Enterprise sector therefore has an essential role in the post-COVID levelling-up agenda. The implications of these findings for service provision are that the Voluntary Community and Social Enterprise sector must be recognised as an integral partner within any effectively functioning local health system and, as such, adequately resourced to safeguard sustainability and to ensure that attempts to involve the sector in addressing the social determinants of health are not jeopardised. Funding: National Institute for Health and Care Research (Applied Research Collaboration North East and North Cumbria (grant reference NIHR200173) and Public Health England. SSo is supported by a Health Education England and National Institute for Health and Care Research Integrated Clinical Academic Lecturer award (reference CA-CL-2018-04-ST2-010) and Research Capability Funding, National Health Service North of England Care System Support. VJM is funded by the National Institute for Health and Care Research School for Public Health Research (grant reference PD-SPH-2015)

“I’ll meet you at our bench”: adaptation, innovation and resilience among VCSE organisations who supported marginalised and minoritised communities during the Covid-19 pandemic in Northern England – a qualitative focus group study

Background: The Covid-19 pandemic has exacerbated pre-existing inequalities and increased adversity and challenges for vulnerable and marginalised communities worldwide. In the UK, the Voluntary Community and Social Enterprise (VCSE) sector play a vital role in supporting the health and wellbeing of people who are marginalised or experiencing multiple complex needs. However, only a small number of studies have focused on the impact that Covid-19 had on the VCSE sector. Methods: As part of a Health Inequalities Impact Assessment (HIIA), we conducted qualitative focus groups with staff and volunteers from five organisations to examine short, medium and longer-term impacts of Covid-19 upon the VCSE sector in Northern England. Nine online focus groups were conducted between March and July 2021. Findings: Focus group transcripts were analysed using Framework Analysis and yielded three central themes: (1) exacerbation of pre-existing inequalities, adversity and challenges for vulnerable and marginalised populations; (2) the ‘price’ of being flexible, innovative and agile for VCSE staff and volunteers; and (3) the voluntary sector as a ‘lifeline’ - organisational pride and resilience. Conclusions: While the voluntary sector ‘adapted at pace’ to provide support during Covid-19 and in its continued aftermath, this resilience has potentially come at the cost of workforce and volunteer wellbeing, compounded by political obstacles and chronic shortage in funding and support. The VCSE sector has a vital role to play in the post-lockdown ‘levelling up’ agenda. The expertise, capacity and resilience of VCSE organisations, and their ability to respond to Covid-19, should be celebrated, recognised and supported adequately to maintain its resilience. To not do so threatens the sector’s sustainability and risks jeopardising attempts to involve the sector in addressing the social determinants of health

Social dynamics in nonbreeding flocks of a cooperatively breeding bird: causes and consequences of kin associations

Kin selection is regarded as a key process in the evolution of avian cooperative breeding, and kinship influences helper decisions in many species. However, the effect of kinship on nonbreeding social organization is still poorly understood despite its potential fitness implications. Here, we investigated the origins and consequences of kin associations in nonbreeding flocks of long-tailed tits, Aegithalos caudatus, an atypical cooperative breeder where helpers are failed breeders that redirect care towards relatives living in kin neighbourhoods. We found that kinship is an important factor in initial grouping decisions; all members of a nuclear family initially joined the same flock and failed breeders chose to flock with their relatives. Flocks that merged during the nonbreeding season also contained relatives. In contrast to these findings of positive kin association, when long-tailed tits switched flocks they tended to disperse into flocks with fewer relatives, although such switches often occurred with kin. In a playback experiment, we found no evidence that aggression shown towards members of other flocks was affected by kinship, indicating that kin associations result from a preference to flock with relatives rather than a constraint on flocking with nonrelatives. Finally, using social network analysis, we show that fine-scale nonbreeding associations among individuals were positively related to kinship, and that these nonbreeding associations were reflected in helping decisions in the subsequent breeding season, in addition to the previously reported effects of kinship and proximity. We conclude that long-tailed tits prefer to associate with kin when not breeding, and suggest that by doing so they gain either nepotistic benefits within flocks or future indirect benefits during breeding

Nigrosome 1 imaging in REM sleep behavior disorder and its association with dopaminergic decline

Objectives Rapid eye movement sleep behavior disorder (RBD) patients have a high risk of developing a Parkinsonian disorder, offering an opportunity for neuroprotective intervention. Predicting near‐term conversion, however, remains a challenge. Dopamine transporter imaging, while informative, is expensive and not widely available. Here, we investigate the utility of susceptibility‐weighted MRI (SWI) to detect abnormalities of the substantia nigra in RBD, and explore their association with striatal dopaminergic deficits. Methods SWI of the substantia nigra was performed in 46 RBD patients, 27 Parkinson’s patients, and 32 control subjects. Dorsal nigral hyperintensity (DNH) was scored by two blinded raters, and separately quantified using a semiautomated process. Forty‐two RBD patients were also imaged with 123I‐ioflupane single‐photon emission computed tomography (DaT SPECT/CT). Results Consensus visual DNH classification was possible in 87% of participants. 27.5% of RBD patients had lost DNH, compared with 7.7% of control subjects and 96% of Parkinson’s patients. RBD patients lacking DNH had significantly lower putamen dopaminergic SPECT/CT activity compared to RBD patients with DNH present (specific uptake ratios 1.89 vs. 2.33, P = 0.002). The mean quantified DNH signal intensity declined in a stepwise pattern, with RBD patients having lower intensity than controls (0.837 vs. 0.877, P = 0.01) but higher than PD patients (0.837 vs. 0.765, P < 0.001). Interpretation Over one quarter of RBD patients have abnormal substantia nigra SWI reminiscent of Parkinson’s, which is associated with a greater dopaminergic deficit. This modality may help enrich neuroprotective trials with early converters